protein A immunoadsorption + rituximab + dexamethasone + azathioprine

This is a combination therapy consisting of four components: - **Protein A immunoadsorption** is an extracorporeal blood purification technique that selectively removes pathogenic autoantibodies from plasma using columns containing Protein A, which binds the Fc region of IgG antibodies. - **Rituximab** is a chimeric monoclonal antibody targeting CD20 on B lymphocytes, leading to B cell depletion and reduced autoantibody production. - **Dexamethasone** is a synthetic glucocorticoid with potent anti-inflammatory and immunosuppressive effects, often administered in high-dose pulses to control severe inflammation. - **Azathioprine** is an oral purine analog immunosuppressant that inhibits DNA synthesis in proliferating cells, particularly affecting lymphocyte proliferation. This combination has been studied primarily for the treatment of severe, treatment-resistant autoimmune diseases such as pemphigus vulgaris. The rationale for this regimen is rapid reduction of circulating pathogenic autoantibodies (via immunoadsorption), profound suppression of B cell-mediated immunity (via rituximab), broad anti-inflammatory effects (via dexamethasone), and maintenance suppression of immune activity (via azathioprine). Clinical studies have shown this approach can induce rapid and durable remission in patients with refractory pemphigus[1][2][9].

Other names

protein A immunoadsorption plus rituximab plus dexamethasone plus azathioprine